Regular-dose versus High-dose Omeprazole in Peptic Ulcer Bleeding A Prospective Randomized Double-blind Study

Udd, Marianne; Miettinen, Pekka; Palmu, A; Heikkinen, Markku; Janatuinen, E; Pasanen, Pentti; Tarvainen, Riitta; Kairaluoma, Matti I.; Lohman, Marta; Mustonen, Harri; Julkunen, Risto

doi:10.1080/003655201317097218

Cited by 73 publications

(5 citation statements)

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“…In preview of such repositioning approach, many recent preclinical and clinical evaluations have highlighted diverse effects of omeprazole other than its proton pump inhibitory actions. Omeprazole is a proton pump inhibitor that is widely used in the treatment of peptic ulcer 7 . In vitro and and in vivo evaluations have proved omeprazole have carbonic anhydrase inhibitory 8 , anti-inflammatory 9 and antioxidant 10 activities.…”

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confidence: 99%

In vivo and in vitro protective effects of omeprazole against neuropathic pain

Chanchal

Mahajan

Siddharth

et al. 2016

Sci Rep

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Apart from reducing the acid secretion, omeprazole inhibits activation of the nuclear factor-κB, release of inflammatory cytokines, and chemotaxis of neutrophils. These mechanisms prompted us to evaluate antineuropathic effect of omeprazole in the chronic constriction injury (CCI)-induced rat model of neuropathic pain and LPS mediated ROS-induced U-87 cells. Omeprazole at 50 mg/kg/day/oral for 14 days significantly reduced the intensity of neuropathic pain estimated as paw withdrawal latency, withdrawal pressure threshold and restored the motor nerve conduction velocity in the constricted nerve, when compared with respective groups. The histological findings revealed the protective effect of omeprazole against the CCI-induced damage. Omeprazole significantly decreased the levels of tumor necrosis factor (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) as compared to their respective control groups. It also reduced the oxidative stress by up regulating the SOD, catalase activity and decreasing MDA content. Similarly, in-vitro study, LPS mediated ROS-induced U-87 cells, omeprazole reduced the oxidative stress as well as the release of TNF-α, IL-1β and IL-6. Altogether, these results suggest that, neuroprotective effect of omeprazole is mediated through preventing release of proinflammatory cytokines, augmenting endogenous anti-oxidant defense system, and maintain the structural integrity of sciatic nerve from the CCI-induced structural damage and inflammatory changes.

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confidence: 99%

In vivo and in vitro protective effects of omeprazole against neuropathic pain

Chanchal

Mahajan

Siddharth

et al. 2016

Sci Rep

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“…Many Western reports have defined that continuous PPI therapy is effective in the prognosis of non-variceal upper gastrointestinal bleeding patients [7]. However, some other European studies reported that there is no statistical significance between intravenous 20 mg once daily omeprazole and continuous infusion of an 80-mg bolus followed by 8 mg/h [12]. In Indian and Iranian studies, oral omeprazole alone 80 mg/day was able to reduce rebleeding rates [13,14,15].…”

Section: Introductionmentioning

confidence: 99%

Intermittent versus Continuous Pantoprazole Infusion in Peptic Ulcer Bleeding: A Prospective Randomized Study

et al. 2008

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Background and Aim: Rebleeding has remained the most important determinant of poor prognosis in peptic ulcer bleeding. Gastric acid plays an important role in the pathogenesis of rebleeding. We aimed to compare the efficiency of intermittent and continuous pantoprazole infusion treatment on peptic ulcer rebleeding after endoscopic therapy. Materials and Method: In this prospective study, patients with active peptic ulcer bleeding or non-bleeding visible vessel were treated initially with endoscopic therapy. They were randomized to receive intermittent or continuous intravenous pantoprazole treatment. Rebleeding rate, duration of hospital stay, need for total blood transfusion and need for urgent surgery were compared among both groups. Results: Rebleeding rate (6.1 vs. 8.3%), duration of hospital stay (4.17 vs. 4.41), need for total blood transfusion (2.18 vs. 2.59) and need for urgent surgery (4.1 vs. 4.2%) were similar in intermittent and continuous pantoprazole infusion therapy groups, respectively. There was no bleeding-related death in either group. Conclusion: In patients with peptic ulcer bleeding, intermittent and continuous pantoprazole infusion after successful endoscopic therapy have comparable outcomes in reducing rebleeding. Both have similar effects on hospital stay, need for blood transfusion and urgent surgery. Intermittent administration has application and cost advantages over continuous infusion.

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“…While in the methods of pantoprazole, there is not any specific dose being established, many studies and trials suggested 80 mg single dose after 40 mg/h for patients with peptic ulcer disease in Asia. [ 32 33 ]…”

Section: Discussionmentioning

confidence: 99%

“…According to other studies, the efficacy of pantoprazole in the Asian patients is more than Western ones. [ 32 33 ] In addition, pH of the stomach was not measured; hence, it cannot be concluded that both methods are identical in reducing and controlling acid. However, it should be noted that whether both methods have any effect on acid control, it does not change the conclusion of the investigation because the effect of the drug was being investigated.…”

Section: Discussionmentioning

confidence: 99%

Efficacy Comparison of Divided and Infusion Intravenous Pantoprazole Methods after Endoscopic Therapy in Patients with Acute Gastrointestinal Bleeding

Motiei

Sebghatolahi

2017

Adv Biomed Res

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Background:Intravenous pantoprazole administration in patients with severe bleeding under urgent endoscopic therapy is effective. Furthermore, its infusion dose is useful to control bleeding; however, it is not economical. In this study, clinical outcomes and intravenous infusion of pantoprazole after endoscopic therapy plus efficacy of infusion dosage and divided doses are compared.Materials and Methods:This prospective, comparative study conducted on 18 adult (>18 years) patients referred to Al Zahra Hospital for hematemesis and melena bleeding who underwent endoscopic treatment with pantoprazole which divided into two groups of forty patients. First group received intravenous infusion for 80 mg and 8 mg/h. The second group received intravenous infusion with divided doses as 40 mg twice daily for 3 days. Clinical outcomes such as rebleeding, duration of hospitalization, amount of blood transfused, and mortality within 3 days after endoscopic treatment were collected and analyzed by SPSS software (version 20) using independent t-test, Chi-square test, and Fisher's exact test.Results:Duration of hospitalization in the pantoprazole infusion group was 5.42 ± 4.62 days, with three patients (7.5%) having rebleeding, and in the divided pantoprazole group was 5.90 ± 3.08 days, with four patients (10%) having rebleeding, and overall, only one person died in the divided pantoprazole group (2.5%) out of eighty patients. No significant difference was observed between two groups in terms of clinical outcomes (P > 0.05).Conclusion:Regarding to results, it can be stated that both methods with specified dosage had significant impact on improvement of hematemesis and melena. Furthermore, due to lower costs, low dose of pantoprazole in divided approach as 40 mg/12 h is proposed.

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Regular-dose versus High-dose Omeprazole in Peptic Ulcer Bleeding A Prospective Randomized Double-blind Study

Abstract: Under the defined tolerance limits, the regular dose of omeprazole is as successful as a high dose in preventing peptic ulcer rebleeding.

Cited by 73 publications

References 25 publications

In vivo and in vitro protective effects of omeprazole against neuropathic pain

In vivo and in vitro protective effects of omeprazole against neuropathic pain

Intermittent versus Continuous Pantoprazole Infusion in Peptic Ulcer Bleeding: A Prospective Randomized Study

Efficacy Comparison of Divided and Infusion Intravenous Pantoprazole Methods after Endoscopic Therapy in Patients with Acute Gastrointestinal Bleeding

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